Provider Demographics
NPI:1164402764
Name:GREENSTEIN, MARC HOWARD (MD)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:HOWARD
Last Name:GREENSTEIN
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:5846 S FLAMINGO RD
Mailing Address - Street 2:#280
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33330-3237
Mailing Address - Country:US
Mailing Address - Phone:954-380-8550
Mailing Address - Fax:954-380-8580
Practice Address - Street 1:400 N HIATUS RD
Practice Address - Street 2:SUITE 206
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-5214
Practice Address - Country:US
Practice Address - Phone:954-380-8550
Practice Address - Fax:954-380-8580
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2022-04-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0061551207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL18568Medicare ID - Type Unspecified
FLF51603Medicare UPIN